In:
Coronary Artery Disease, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. 4 ( 2021-06), p. 317-328
Abstract:
Coronary artery calcium (CAC) is an indicator of atherosclerosis, and the CAC score is a useful noninvasive assessment of coronary artery disease. Objective To compare the risk of cardiovascular outcomes in patients with CAC 〉 0 versus CAC = 0 in asymptomatic and symptomatic population in patients without an established diagnosis of coronary artery disease. Methods A systematic search of electronic databases was conducted until January 2018 for any cohort study reporting cardiovascular events in patients with CAC 〉 0 compared with absence of CAC. Results Forty-five studies were included with 192 080 asymptomatic 32 477 symptomatic patients. At mean follow-up of 11 years, CAC 〉 0 was associated with an increased risk of major adverse cardiovascular and cerebrovascular events (MACE) compared to a CAC = 0 in asymptomatic arm [pooled risk ratio (RR) 4.05, 95% confidence interval (CI) 2.91–5.63, P 〈 0.00001, I 2 = 80%] and symptomatic arm (pooled RR 6.06, 95% CI 4.23–8.68, P 〈 0.00001, I 2 = 69%). CAC 〉 0 was also associated with increased risk of all-cause mortality in symptomatic population (pooled RR 7.94, 95% CI 2.61-24.17, P 〈 0.00001, I 2 = 85%) and in asymptomatic population CAC 〉 0 was associated with higher all-cause mortality (pooled RR 3.23, 95% CI 2.12–4.93, P 〈 0.00001, I 2 = 94%). In symptomatic population, revascularization in CAC 〉 0 was higher (pooled RR 15, 95% CI 6.66–33.80, P 〈 0.00001, I 2 = 72) compared with CAC = 0. Additionally, CAC 〉 0 was associated with more revascularization in asymptomatic population (pooled RR 5.34, 95% CI 2.06–13.85, P = 0.0006, I 2 = 93). In subgroup analysis of asymptomatic population by gender, CAC 〉 0 was associated with higher MACE (RR 6.39, 95% CI 3.39–12.84, P 〈 0.00001). Conclusion Absence of CAC is associated with low risk of cardiovascular events compared with any CAC 〉 0 in both asymptomatic and symptomatic population without coronary artery disease.
Type of Medium:
Online Resource
ISSN:
0954-6928
DOI:
10.1097/MCA.0000000000000974
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2021
detail.hit.zdb_id:
2042449-8
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